SIED-GISCOR recommendations for colonoscopy in screening programs: Part I - Diagnostic.

Area of Science:

• Gastroenterology
• Public Health
• Cancer Screening

Background:

• Fecal immunochemical testing (FIT) programs effectively reduce colorectal cancer (CRC) incidence and mortality.
• The success of FIT programs hinges on high-quality colonoscopies for FIT-positive individuals to detect and remove advanced lesions.
• Ensuring the benefit-to-harm ratio of post-FIT colonoscopy requires attention to diagnostic phase quality.

Purpose of the Study:

• To provide guidance on standardizing colonoscopy quality within organized FIT programs.
• To focus on the diagnostic phase of colonoscopy for FIT-positive subjects.
• To optimize the benefit/harm ratio of post-FIT colonoscopy.

Main Methods:

• Review of evidence on factors influencing colonoscopy quality in FIT programs.
• Development of recommendations for standardizing colonoscopy procedures.
• Focus on key aspects of the diagnostic colonoscopy phase.

Main Results:

• Identified critical factors influencing colonoscopy quality post-FIT.
• Provided indications for standardizing colonoscopy in FIT-positive subjects.
• Highlighted the importance of specific procedural elements.

Conclusions:

• Standardizing colonoscopy in FIT-positive individuals is essential for maximizing the efficacy of CRC screening programs.
• Interventions targeting colonoscopy quality can enhance CRC morbidity and mortality prevention.
• Attention to timing, antithrombotic therapy, bowel preparation, competence, and sedation is key.